Medication dispensing

ABSTRACT

The disclosure herein describes an improved system of dispensing medicine in hospitals; it includes a novel envelope for ordering and obtaining from the pharmacy the medication prescribed for a patient. Indicia representative of the medication and of the patient being administered the medication appear on the flap of the envelope and on the envelope itself. When the envelope is received in the pharmacy, the person responsible removes the detachable flap and files it; he, then, fills the pocket of the envelope with the medication prescribed. The system further includes an improvement in the construction of the package strip of the type having medication containing sealed compartments and being severable between the compartments; the strip is provided with a detachable continuously flat tail portion on which information relating to the medication contained in the sealed compartments is indicated. This tail portion is then affixed on the envelope to show that the medication has been administered to the patient according to the delivery period also indicated on the envelope.

United States Patent [191 Phillips NOV. 20, 1973 MEDICATION DISPENSING[75] Inventor: George F. Phillips, Laval, Quebec,

Canada [73] Assignee: The North American Dye Corporation Limited,Montreal, Quebec, Canada [22] Filed: July 14, 1971 [21] Appl. No.:162,389

Primary Examiner-Herbert F. Ross Assistant Examiner-Stephen P. GarbeAttorneyCushman, Darby & Cushman 57 ABSTRACT The disclosure hereindescribes an improved system of dispensing medicine in hospitals; itincludes a novel envelope for ordering and obtaining from the pharmacythe medication prescribed for a patient. Indicia representative of themedication and of the patient being administered the medication appearon the flap of the envelope and on the envelope itself. When theenvelope is received in the pharmacy, the person responsible removes thedetachable flap and files it; he, then, fills the pocket of the envelopewith the medication prescribed. The system further includes animprovement in the construction of the package strip of the type havingmedication containing sealed compartments and being severable betweenthe compartments; the strip is provided with a detachable continuouslyflat tail portion on which information relating to themedication-contained in the sealed compartments is indicated. This tailportion is then affixed on the envelope to show that the medication hasbeen administered to the patient according to the delivery period alsoindicated on the envelope.

,. .4 12 rayine fi rs PAIENIEI] NOV 20 1975 WWI- INVENTOR 59 GeorgeFPH/LL/PS BY MZMJH ZQLN PATENTEUHUY 20 ms 3.773.250

SHFFT 3 [IF 3 INVENT'OR George F PH/LL/PS izda izgmmim MEDICATIONDISPENSING The present invention relates to medication dispensing; moreparticularly, the invention relates to an improved system for dispensingmedication to patients in hospitals.

Generally, tablets and capsules containing medication, are kept inbottles labelled to identify the contents. Because of the small size ofthe capsule or tablet and a few identifying colors and combinations andletters available, there is no way of positively identifying the tabletor capsule once removed from labelled bottles. In the hospitals, when adrug is ordered for a patient, a drug requisition is prepared at theward and sent to the pharmacy on a business form which is usually madein several copies. When the order arrives in the pharmacy, thepharmacist must check the prescription for accuracy, give it a filenumber, type a label, individually count the number of tablets orcapsules, put them into another vial, box or envelope, attach the labeland return the package to the ward. When the package arrives at theward, it is usually stored in a medicine cupboard controlled by amedication nurse who has to review every hour her drug requirements bypatient, dispense one or more tablets as required by the prescription,put them in a small cup on which the patients identification has beenpencilled and assemble these on a cart; then she goes about deliveringthem to the ward.

The medication nurse takes the cart to the ward, identifies the patient,identifies his or her particular cup containing the medication, placesthe capsules in the patients hand and gives the patient a glass of waterand witnesses the taking of the medicine. It can be seen by thisprocedure that, once the medication leaves the vial or container inwhich it gets to the medication nurse, she has no way of identifyingpositively the medication. She might, for example, have half a dozencups with half a dozen white pills indistinguishable one from the other.

Having regard to this generally accepted traditional way of dispensingoral medication in a hospital, it is an object of the present inventionto provide a greater degree of accuracy assuring that the propermedication gets to the proper patient, to improve the efficiency from alabor standpoint, both in the pharmacy and at the ward level, and toreduce the cost of disposable materials which are needed in thedispensing of the medication.

The method of dispensing medication in accordance with the presentinvention is generally as follows. The medication is ordered from thepharmacy by the ward in an envelope provided with a flap. On both theenvelope pocket and the flap are printed identical forms which areessentially prescription forms to receive and convey the preciseinformation for any given prescription. Filling in the form on the flapof the envelope, the prescription is copied onto the face of theenvelope by carbon paper or by other suitable duplicating means. Whenthis envelope with the order on it arrives in the pharmacy, thepharmacist checks for accuracy, removes the detachable flap, numbers it,and files it in his permanent prescription file.

In order to fill a prescription, the pharmacist proceeds to a rack ofdispensers of a type having a number of side-by-side pockets, eachcontaining a roll of medication. A typical roll is a sealed packagestrip in which consecutive compartments contain individual tablets orcapsules and are separated from one another by a seal extending aroundthe compartment. According to one aspect of the invention, a tear-ofltail portion being continuously flat is provided running down the sideof the strip. The tear-off tail portion has the name of the product inplain descriptive language for easy identification by the medicationnurse and is cross-referenced to a code number which is printed directlyon the other part of the strip containing the medication; this is toprevent recognition by the patient of the medication being administered.In addition to the code markings, the compartments are consecutivelynumbered to facilitate counting by the pharmacist as he retracts thestrip from the dispenser.

As the pharmacist fills the prescription, he tears off the desirednumber of pockets from the body of the strip, inserts them in theenvelope, returns the envelope to the ward for further processing by themedication nurse. At the top of the envelope is a time code and thenurse, using a colored marker, clip or colored pencil, indicates thetimes at which the medication is to go to the patient. She then filesthe envelope in a storage box according to room and bed number. At agiven delivery period, the medication nurse takes the storage box forthe ward to be served and places it on a cart. The alignment of thecolor markers for that particular hour indicate which envelopes arescheduled for delivery. She can then select immediately the ones whichhave to be administered at that particular hour. She proceeds by roomorder to the patient, identifies each patient, checks the medicationagainst the original written order which appears on the front face ofthe envelope, identifies the medication by means of the detachable tailportion along the side, tears the tail portion from the strip, affixesit on the front face of the envelope and registers the time at which themedication was administered. She then tears open the compartmentandadministers the medication.

Having thus generally described the system, it will be referred to inmore detail by reference to the accompanying drawings, in which: 1

FIG. 1 is a front perspective view of an envelope'used in accordnacewith the present invention and shown in a folded position;

FIG. 2 is a perspective view of the envelope in FIG. 1 in an unfoldedposition;

FIG. 3 is a front elevational view of the front face of the pocket ofthe envelope shown in FIG. 2;

FIG. 4 is a front perspective view of a dispensing cabinet;

FIG. 5 is a perspective view of a carton used for transporting the stripsealed medication and for loading the dispenser shown in FIG. 4',

FIG. 6 is a vertical cross-section showing the dispensing cabinet ofFIG. 4 tilted forward in loading position for the carton of FIG. 5;

FIG. 7 is a fragmentary perspective view showing part of a roll of stripsealed medication;

FIG. 8 is a perspective view showing a tailportion being detached fromone medication pouch;

FIG. 9 is a perspective view showing a storage box loaded with envelopepockets according to FIG. 3 with protruding time tabs;

FIGS. 10 and 10a are respectively perspective and side views of the timetabs illustrated in FIG. 3; and

FIG. 1 1 illustrates a cart in which one or more boxes of FIG. 9 may bestored.

Referring to the drawings, like reference numerals will designate likeor corresponding parts throughout.

The medication to be administered to a patient is ordered from thepharmacy by the ward in an envelope shown in FIGS. 1-3. The envelope 20includes a medication-receiving portion 22 having a front wall 24 and arear wall (not visible); the two walls are attached along three sidesthereof thereby defining a pocket with an opening 26 at its upperportion. Wall 24 has a front face bearing a series of printing blocks28, 29 and 30 for receiving indicia representative of the patients nameand room number and of the medication to be administered to him; anotherblock is for the pharmacists use for checking purposes. Blocks 28, 29and 30 may cover the entire front face of wall 24 or may be disposed asshown in FIG. 3, leaving one area on the left-hand side of the pocketfor another printed form 32; the upper portion of the front wall 24 isprovided with time code 33, identifying, for example, the hours of theday.

Envelope 20 also consists of a foldable and detachable flap 34 which isthe continuation of the rear wall of the envelope; the flap has a tearline 36, such as a weakened line formed of perforations and extendingtransversely at the opening 26 of the envelope. The flap 34 has a frontface 38, continuous with the outside face of the rear wall of the pocket22, and a rear face 40 adapted to overlap the front wall 24 of thepocket. Face 38 bears a series of blocks 42, 43 and 44-to receive thesame information written on blocks 28, 29 and 30 of pocket 24;therefore, the blocks on face 38 are preferably in alignment with theblocks on face 24 when flap 34 is folded to overlay the front side ofthe envelope. The underface 40 of the flap is thus provided withsuitable duplicating means, such as carbon paper, so that everythingwritten on the face 38 of the flap is simultaneously transcribed on thefront face of the pocket.

When the envelope 20 with blocks 28 and 42, 29 and 43 filled with thenecessary information arrives at the pharmacy, the pharmacist checks foraccuracy and if so, initials the envelope at the indicated location(block 44). The pharmacist then removed the detachable flap 34, numbersit and files it in his permanent prescription file. If the envelope isnot prenumbered, he numbers it.

In order to fill a prescription, the pharmacist proceeds to a rack ofdispensers of the type having a num ber of side-by-side pockets eachcontaining a medication-strip of the type having a plurality of packagecompartments formed therein. Such a dispenser is shown in FIG. 4 andreferred generally by numeral 46. Dispenser 46 comprises a base 48having fixed thereon a plurality of laterally spaced vertical partitions50 which subdivide the interior of the dispenser into a plurality ofstrip-containing chambers 51. A rectangular shaped transparent face 54extends over the front edge 52 of each partition 50 and has a bottomedge 56 distant from base 48 so as to leave between each partition anopening 58. Referring to FIG. 6, the dispenser 46 is adapted to pivot ina rack 55, shown in broken lines, to receive one or more box-likecontainers or cartons 56 enclosing a medication-strip 66. The carton mayslide into the dispenser between two partitions 50 or the strip mayfirst be removed from the carton and then inserted in the chambers 51.If carton 56 is inserted between the partitions, the front edge or panel59 thereof can be seen through the transparent wall 54 of the dispenser;it then serves as a label for the identification of the medicationinside the carton. The lower portion of the panel is made detachablefrom the carton for the release of the package compartments of the stripthrough the opening 58. In cases where the medicationstrip is removedfrom the carton before being inserted between the partitions, the cartonis constructed to render detachable the front edge 59 which is theninserted against the inside face of the transparent wall 54',appropriate guideways (not shown) may be provided on the partitions orthe inside surface of the transparent face for the insertion and theholding of the panels 59 against the transparent wall. The rear edge 60(see FIG. 5) of the carton could also be made detachable to display thesame labelling but in another language. As shown in FIGS. 4 and 6, thelower extremity of the front edge 59 extends below the edge 56 of wall54 and thereby forms a flap 62 which controls the release of packagesfrom the dispenser and which also serves to facilitate the counting ofthe packages as they are pulled out.

Referring to FIGS. 7 and 8, the strip 66 consists of a flexible packagecomprising a medication containing portion 68 and a detachable tailportion 70 having no compartments. Portion 68 is formed of two layers 72and 74 of flexible packaging material and sealed together along thelongitudinal edges thereof and transversely at spaced internals to formbetween the layers a plurality of medication-containing compartments 76,represented by protuberances 77 in FIGS. 7 and 8. These compartments aredivided transversely by tear lines 78, such as perforations tofacilitate severing of individual package from the strip 66. Thedetachable tail portion 70 extends along one longitudinal edge of themedication-containing portion 68. The tail portion of each package isdefined by transverse tear lines 80, extending in the prolongation ofthe transverse tear lines 78 of the medication-containing portion 68,and by a longitudinal tear line 82 extending between portions 68 and 70.These lines are weakened such as by scoring. Tear lines 78, 80 and 82enable individual packages to be torn from the strip and the tailportion 70 to be torn from each package. The packages are consecutivelynumbered and each tail portion of each package carries indiciaidentifying the name of the product in plain descriptive language; thisidentification is cross-referenced to a code number which is stampeddirectly on the rear of portion 68 which contains the tablet or capsule84; this is to prevent recognition of the medication by the patient.

As the pharmacist fills a prescription, he tears off the desired numberof packages from the body of the strip, inserts them in the pocket ofthe envelope, returns the envelope to the ward for further processing bythe medication nurse. The nurse clips on the time code 33 printed at thetop of the envelope 22 the transparent markers 88, shown in FIGS. 10 and10a,to indicate the hours at which the medication is to be administeredto the patient.

The medication nurse then files the envelope in a storage box (see FIG.9) according to room and bed number. At a given delivery period, themedication nurse takes the storage box 90 for the ward to be served andplaces it on a cart 92 (see FIG. 11). The alignment of the transparentmarkers for that particular hour indicates which envelopes are to bescheduled for delivery.

The person responsible can select immediately the ones which have to beadministered at a particular hour. The person then proceeds, by roomorder, to the patient, identifies each patient, checks the medicationagainst the original written order appearing on face 24 of the envelope,identifies the medication by means of the detachable tail portion 70,tears open the pocket and administers the medication. The torn tailportion 70 is adhesively secured on the printed form 32 appearing onface 24 of the envelope; to achieve this, the front face of the envelopemay be provided with detachable selfstick segments which, when removedfrom block 32, leave an adhesive residue to permit affixing of the tailportion 70 of the medication-strip. The nurse indicates the time atwhich the medication was administered to the patient and initials at theappropriate location.

Although the invention has been described above in relation to specificforms of the invention, persons skilled in the art will be aware that itmay be refined and modified in various ways. For example, the presentinvention is not limited to oral medication dispensing; pouchescontaining ointments, powders and liquids may be processed in accordancewith the present invention, and ampoules and vials of injectablematerials for parenteral use may be strip-sealed. It is therefore wishedto have it understood that the present invention is not limited ininterpretation except by the terms of the following claims.

The embodiments of the invention in which an exclusive property orprivilege is claimed are defined as follows:

l. A package strip comprising:

an elongate body including a medication-containing portion formed of twolayers of flexible material, said medication-containing portion beingsealed along the longitudinal edges thereof and transversely at spacedintervals to form between said layers a plurality of medicationenclosing compartments, said compartments being divided longitudinallyby transverse tear lines for severing one or more individual packagesfrom the body;

said body further including a detachable indicia bearing, continuouslyflat tail portion disposed outside said sealed medicationcontainingportion and extending along one of said longitudinal edges of saidmedication-containing portion, said flat tail portion having a series oflongitudinally spaced transverse lines extending in the prolongation ofthe transverse tear lines of the medication enclosing compartments and alongitudinally extending tear line dividing said flat tail portion fromsaid sealed medication-containing portion to thereby form a detachabletear-off section for each of said individual packages.

2. A package strip as defined in claim 1 wherein the indicia isrepresentative of medication adapted to be enclosed in the associatedcompartment.

3. A package strip as defined in claim 2 wherein said tear lines arescored for easy tearing of the individual packages and their tear-offsections.

4. A package strip as defined in claim 3 wherein said compartments areconsecutively numbered.

1. A package strip comprising: an elongate body including amedication-containing portion formed of two layers of flexible material,said medicationcontaining portion being sealed along the longitudinaledges thereof and transversely at spaced intervals to form between saidlayers a plurality of medication enclosing compartments, saidcompartments being divided longitudinally by transverse tear lines forsevering one or more individual packages from the body; said bodyfurther including a detachable indicia bearing, continuously flat tailportion disposed outside said sealed medication-containing portion andextending along one of said longitudinal edges of saidmedication-containing portion, said flat tail portion having a series oflongitudinally spaced transverse lines extending in the prolongation ofthe transverse tear lines of the medication enclosing compartments and alongitudinally extending tear line dividing said flat tail portion fromsaid sealed medication-containing portion to thereby form a detachabletear-off section for each of said individual packages.
 2. A packagestrip as defined in claim 1 wherein the indicia is representative ofmedication adapted to be enclosed in the associated compartment.
 3. Apackage strip as defined in claim 2 wherein said tear lines are scoredfor easy tearing of the individual packages and their tear-off sections.4. A package strip as defined in claim 3 wherein said compartments areconsecutively numbered.